HomeMy WebLinkAboutNCG060081_2022 DMR_20220729NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
Food and Kindred
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Complete, sign, scan and submit the DM via the Stormwater NPDES Permit Data Monitoring Report fDMRI Upload farm within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG06 Co S [
Person Collecting Samples: 'I m 1W C CLn1e_,► 15-
Facility Name: (1c, I�jr!`C oPtF-k-TI aJQS --5 Pc
LaboratoryName: WA O f N t AmA -RcAL-
Facility County; L [ �C. L I`J Li
Laboratory Cert. No.: U'L
Discharge during this period: ffYes ❑ No (if no, skip tosignarure anddate)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https:l/edocs.deg .nc.eov/FormslSW-DMR es ❑ No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities -- l3enchmarks in (Red)
Parameter
Code
Parameter
Outfall
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Cfass
00 f
❑o 3
00
Ci n
N/A
Date 5ampte Collected MM/DD/YYYY
L�11Li 12'
LO/I L4 Z2
& /I,I LZ
(C /1
(a ll cl 2 Z
46529
24-Hour Rainfall in inches
p • c//p
Q, U (--
0- c,1
0. 4 &
C0530
T55 in mg/L (100 or 50*)
L
<? L1 ny L
=`�kt �,
+�{ ►lt L
�,,� N( '
00400
pH in standard units (6.0 - 9.0 FW,
'� l
��
v
�,�
I G
(Q 0
6.8-8.5SW)
31616
Fecal Coliform per 100 ml of
freshwater (if required) (1000)
61211
Enterocacci per 100 ml of saltwater
(if required) (500)
00340
Chemical Oxygen Demand in mg/L
{SUM Jt
�5L}K JL
(120)
Additional parameters for outfalls in drainage areas that use a55 gallons per month of new hydraulic oil on average
NCOIL
Estimated New Motor/Hydraulic Oil
]�
Usage in gal/month
u �f� 1
'2i
00552
Non -Polar Oil & Grease in mg/L (15)
SIPM'
.c jrt{ L
[ S-& jW
* Outfalls to Outstanding Resource Waters (QRW), High Quality Waters (HQW), Trout Waters (Tr) and Prlmary Nursery Areas (PNA)
have a benchmark TS5 limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) SW (Saltwater)
Notes (optional):
"I certify by my signature below, under penalty of law, that this document and all attachments were prepared under my direction or supervision in
accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my
inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information
submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
false injDgriation, including the possibility of fines and imprisonment for knowing violations."
Sign ature5f Perm ittee or Delegated Authorized Individual
rex%-f LIeI►tO@s C,JC( C &.ri jv 11c(eA'c( FCe)11-\
Email Address
qIsiLet /,gj_
Date
956 321-3Z(oo
Phone Number